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To be honest. the vaccination recommendations for diabetes have been shrouded in a veil of mystery for me, until this year.
Thankfully, the 2022 ADA Standards are wonderfully clear in describing the vaccination schedule and types for people living with diabetes. We created this simple chart that you are free to download and share with your colleagues and in your work setting.
Even though these vaccine recommendations are well established, I thought it would be interesting to find out what percentage of people actually get the complete compliment of recommended vaccinations.
According to the CDC data, among those with diagnosed diabetes, the vaccination coverage for influenza, pneumococcal, and shingles was lowest among lower income adults and varied by race and ethnicity. Hepatitis B vaccination coverage was lowest among poor adults, and it decreased with age.
As diabetes specialists, we can have a significant impact on encouraging people with diabetes to receive these important vaccinations. We can work within our health care systems to establish systems and surveillance to monitor vaccine participation. Partnering with community health workers and liaisons can create bridges to increase vaccination rates.
Vaccination Rates for People with Diabetes:
Given that most experts predict that severe acute respiratory syndrome coronavirus 2 (SARSCoV-2) and influenza viruses will both be active in the U.S. during the 2021–2022 season, getting the influenza vaccine is especially important.
Most people don’t know that getting the Influenza vaccine decreases risk of death.
New data is revealing that the influenza vaccine doesn’t just lower the risk of getting the flu, it also lowers risk of all cause mortality and cardiovascular events and death. This simple annual intervention is recommended for all individuals with diabetes 6 months and older.
See Table 4.5 in ADA Standard 4, 2022 for complete info
This library of critical information is designed for individuals or groups of diabetes specialists, including RNs, RDs, Pharmacists, Nurse Practitioners, Clinical Nurse Specialists, Physician Assistants, and other health care providers interested in staying up to date on current practices of care for people with diabetes and preparing for the BC-ADM or the CDCES certification Exam.
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[yikes-mailchimp form=”1″]The use of DES products does not guarantee the successful passage of the CDCES exam. CBDCE does not endorse any preparatory or review materials for the CDCES exam, except for those published by CBDCE.
A study examining 48,000 people in Scotland over a 14 year period showed those born with a birth weight below 2.893 kg (6.38 lbs) developed type 2 earlier and at a lower BMI than those with a birth weight above 3.572 kg (7.87 lbs).
The results show a potential association between low birth weight and a more severe phenotype of type 2 diabetes, where less insulin is produced.
“It has long been established that being born with low birth weight is associated with increased risk of diabetes and cardiovascular disease in later life. This probably reflects a combination of genetics and intrauterine environment,” the study’s author Christian Paulina said.
Those with a birth weight under 2.893 kg were diagnosed with diabetes at the average age of 50, whereas the average age of diagnosis for those with birth weight above 3.572 kg was 51.3. The researchers noted that for every 1 kg in extra birth weight, diagnosis age was pushed out by .8 years.
More research is needed for clinical applications, but researchers hope to improve birth weight by reducing maternal smoking or improving maternal nutrition. Read the full study here.
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Join us live with your questions on November 1, 2019 @ 11:30 a.m. PST!
Coach Beverly offers this FREE webinar to help get you prepare for the CDCES Exam. All her tips and tricks are meant to ease your mind and reflect the updates to the CDCES content outline. Register below with a name and email and you can join us live next Thursday!
Topics covered include:
We will review sample test questions and the reasoning behind choosing the right answers.
After registering, you will receive a confirmation email containing information about joining the webinar.
Intended Audience: This FREE webinar is designed for individual or groups of diabetes educators, including RNs, RDs, Pharmacists, Nurse Practitioners, Clinical Nurse Specialists, Physician Assistants and other health care providers interested in achieving excellence in diabetes care and becoming Certified Diabetes Care and Education Specialists®.
Instructor: Beverly Thomassian RN, MPH, CDCES, BC-ADM is a working educator who has passed her CDCES Exam 6 times. She is a nationally recognized diabetes expert for over 25 years.
See our Preparing for CDCES Resource Page >>
Sign up for Diabetes Blog Bytes – we post one daily Blog Byte from Monday to Friday. And of course, Tuesday is our Question of the Week. It’s Informative and FREE! Sign up below!
[yikes-mailchimp form=”1″]For Question of the week, test takers usually choose the correct answer 70-80% of the time. However, for this Tuesday’s question of the week, about 44% of respondents chose the correct answer.
So, we thought this would be a perfect opportunity for another answer rationale. We’ll explore this question and the best answer in more detail and throw in some test-taking tips along the way.
Question of the week on October 22:
TR is a 17-year-old with prediabetes who is graduating high school and moving out of state to college and will be living with a roommate in the dorms. TRs mom arranges to have an appointment with the diabetes educator before TR heads off to college. Which of the following is the most important issue to review during the visit?
Answer Options:
As shown above, the most common choice was option 3, the second most common answer was option 2, then option 1, and finally option 4.
Congratulations! A majority of people still answered the question with the right answer.
Option 3 (C) is the correct answer: Vaccinations and how to access medical care. In this scenario, TR is only 17 with prediabetes and the question does not mention that TR is taking any medications or has any prediabetes related complications. Given that, the best intervention is to focus on prevention (vaccines) and how to access health care in this new environment.
Option 1 is incorrect because it says alcohol consumption can increase glucose levels, but alcohol is associated with a lowering of blood glucose. This is because when the liver is metabolizing alcohol, glycogenolysis is hampered resulting in lower blood glucose levels.
Option 2 is incorrect because this scenario doesn’t mention TR is on any medications or prescriptions, so this juicy answer assumes facts not in the question. If one assumes TR is on medication because they have prediabetes, organization of medication and prescription refills could be an important thing to consider before going off to an unfamiliar environment. However, since the scenario doesn’t mention medication, and a 17 year old with prediabetes is not likely be only any medications, this answer is also incorrect.
Finally, option 4 is incorrect because in this scenario, hypoglycemia isn’t mentioned. For people with diabetes, hypoglycemia is a risk when treating diabetes with insulin or sulfonylureas, but this scenario doesn’t mention TR being on either.
We hope you appreciate this week’s rationale and keep studying hard! Thank you so much for taking the time to answer our Question of the Week and participate in this fun learning activity!
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[yikes-mailchimp form=”1″]What is the best way to dispose of expired medications or those that are no longer of use?
October 26 (this Saturday!) is National Prescription Drug Take Back Day. Between 10 a.m. and 2 p.m., collection sites across the U.S. will take all kinds of medications, no questions asked.
People with diabetes take a myriad of medications to keep healthy and maintain quality of life. Many of them are expired and need to be properly disposed of.
In addition, people with diabetes often use antidepressants and opioids used to combat pain. These types of prescription drugs, found in medicine cabinets, are often a primary source for misused medicines. They also increase risk of accidental overdose by young children.
50% of people who misused prescription painkillers got them from a friend or family member.
Recover Together has created a constantly updated map of collection centers that will participate in Take Back Day to help with the safe disposal of medications.
Beyond that, Google Maps will be helping so that if you search “medication disposal near me”, pharmacies, hospitals, police stations, and other locations that accept medications year-round will pop up.
National Take Back Day raises awareness on the importance of safe disposal of drugs. This includes environmental risks, health risks, accidental use, and intentional misuse.
According to the EPA, most water treatment facilities cannot filter out drugs. Medicines that are poured down the drain can enter our environment and community drinking water supplies.
Read more about health concerns and drug facts, and find a medication disposal location at Recover Together.
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James Keck, MD, set out to find if adult patients at an academic family medicine clinic, who were actively screened for prediabetes, received a referral to the Diabetes Prevention Program.
The research team evaluated the electronic health records of 5,360 adult patients at an academic family medicine clinic to determine whether they received pre-diabetes screening, diagnosis and treatment.
They found that:
Even though 35% of patients met the diagnostic cut off for prediabetes, not one of them was referred to a Diabetes Prevention Program.
Keck and colleagues also reviewed 31 surveys from clinicians from the same clinic about their pre-diabetes attitudes, knowledge and practices. Keck noted that even when clinicians are aware of the program, insurance coverage for such programs is low even though more and more insurers are recognizing the wisdom in these prevention programs.
James Keck, a physician at the University of Kentucky, believes this is due to a lack of awareness about the Diabetes Prevention Program in general.
The lack of electronic or streamlined referrals to these programs is another notable barrier, besides perceptions of the clinician and individual of whether the program will be effective.
Raising awareness about the National Diabetes Prevention Program is the first step, as well as raising awareness of private insurance and Medicare which now covers such programs. Finally, increasing relationships between clinics and places offering these programs (or encouraging clinics to start up their own programs) is a great step towards removing barriers.
Read more on the full survey results and recommendations on Healio.
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[yikes-mailchimp form=”1″]Whether it’s the candy, the turkey, stuffing, or the desserts, the holidays are a difficult time for anyone to eat healthy and avoid weight gain. Experts suggest that the holidays are not the best time to set weight loss goals. Instead, a more realistic approach is to focus on enjoying special events and weight maintenance coupled with lots of good self-care.
Weight watchers, most dietitians, and health bloggers suggest several strategies to make healthier choices when tempted by holiday fare:
Some interesting, alternative strategies that people are reporting success with:
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A three-year long study showed real time continuous glucose monitoring (rtCGM) was associated with lower A1c levels in people with type 1 diabetes, whether the participants used pumps or multiple daily injections.
In the study, participants checked glucose levels using CGM or fingersticks four times per day.
Only the real time CGM group had improvements in time-in-range and reduced time below range, regardless of whether they used an insulin pump or injections.
Also, fewer participants using real time CGM experienced severe hypoglycemia.
This three-year study came from the Comparison of Different Treatment Modalities for Type 1 Diabetes Including Sensor-Augmented Insulin Regimens (COMISAIR). The group still advocates for individualization of treatment, but emphasizes what an important difference incorporating real time CGM makes.
Jan Soupal presented the study findings at the European Association for the Study of Diabetes 2019 Annual Meeting in the Czech Republic. Soupal noted that CGM can be coupled with multiple daily injections for those who prefer to only have one device on their body or worry about accessibility and affordability.
Read the full study details here.
Want more valuable CGM info for the test?
Check out our Technology Toolkit! Two fantastic courses included for a total of 3 CEs:
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